Case Study Of Full Mouth Rehabilitation In An Esthetically Motivated Patient With Compromised Posterior Support

Cole S. Bender

Bender, Cole S.
Faculty / Advisor: Deakins, Nicole
University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences


A 57 year old female patient presented to PCU with the chief complaint “I want to get implants to replace my teeth”. She would also like to improve her smile, making her teeth “a better color and shape”. An intraoral examination and review of a full mouth series of radiographs yielded many missing teeth, recurrent caries on existing restorations, and a history of root canal therapy. In order to satisfy the patient’s chief complaint and safely restore her dentition to a stable, healthy state, an extensive full mouth rehabilitation would be necessary. This paper looks to examine various treatment options and evaluate the success of the agreed upon treatment plan.


First, the patient was presented with different treatment plan options. The “gold” treatment included extraction of the remaining six mandibular teeth and #10 due to being compromised by periodontal disease and recurrent caries, respectively. Then, three maxillary implant crowns to replace missing teeth and two mandibular implants to attach to an overdenture. The “silver” treatment plan was similar, except that fixed bridge restorations would be used in the maxilla instead of implant crowns. Finally, the “bronze” treatment plan consisted of one fixed bridge restoration from #9-11 and an immediate mandibular denture.


The patient chose the “silver” treatment plan. Phase one treatment was removal of teeth #10, 22-24, 26, 27, 29 with ridge preservation between tooth sites #22-27 in preparation for the implant-retained mandibular overdenture. After the surgical procedure, a mandibular immediate denture was delivered with a tissue conditioner reline to ensure comfort and retention. Phase two began with removal of the maxillary PFM crowns so that restorability of the abutment teeth could be assessed. #11 had an existing cast post and core with recurrent caries and inadequate root canal therapy- the tooth was referred to the endodontic department for retreatment and placement of a new post and core. Next a PMMA provisional was delivered to evaluate esthetics and function. Finally, the patient was restored with a full maxillary arch ceramic restoration and is planned for implant placement in the mandibular arch.


In a patient that is interested in improving her smile and replacing missing teeth that presents with significantly compromised posterior support, it was found that an implant supported overdenture and a full maxillary arch ceramic restoration was adequate in satisfying the patient’s chief complaint and safely restoring a full mouth dentition.